Insurance

When it comes to what insurance covers cosmetic surgery, it is important to understand that your regular health insurance does not cover most procedures if they are only for cosmetic purposes. For example, cosmetic procedures like a tummy tuck, butt lift, and breast enhancement are typically not covered by regular insurance. If you are having a procedure that is only for cosmetic purposes, your typical health insurance is unlikely to cover any of the costs.

Health insurance is designed to help you with expenses for anything that is a necessity when it comes to your overal physicall health. Plastic surgery is an investment in yourself. It is intended to help you to feel better about a feature or part of your body that has disappointed you in some way. Whether you want to sculpt your figure, enhance your breasts, restore your figure after pregnancy, reduce wrinkles or even trim down your nose, an experienced plastic surgeon will be your guide. Do your research with your health insurance provider to find out if any type of insurance covers cosmetic surgery.

Cosmetic surgery can be very expensive, with the total cost comprised of physician fees, surgical materials (like implants); operating room costs, anesthesia, and post-surgical garments. One common question perspective patients have when considering costs is whether their medical insurance plan will cover the procedure.

In general, each specific insurance company determines what procedures they will or will not cover. The biggest factor insurance companies consider is whether the procedure is reconstructive or cosmetic in nature. To this end many insurers use definitions provided by the American Medical Association (AMA) as follows:

Reconstructive surgery refers to procedures performed to correct trauma, developmental defects, infection, or disease. Reconstructive procedures focus on improving function or normalizing appearance of the patient.

Cosmetic surgery refers to procedures that are focused on improving the aesthetic appearance of the face or body to improve a patients’ appearance or self-esteem.

Many insurance companies, however, can interpret the above definitions differently depending on the specific procedure and situation. For example, the circumcision of boys was universally covered by insurance companies a decade ago. Today, more and more insurance companies are declining coverage as they consider circumcision to be cosmetic.

Due to these variances, it is very important to contact your insurance provider and discuss how your procedure will be classified. While plastic surgeons (and their office coordinators) can counsel you on the potential for insurance coverage it’s always best to go to the source. If insurance will cover the procedure you want, you will have to schedule a consultation with your plastic surgeon to evaluate your case and provide a diagnosis and treatment plan.

Finally, you will need to contact your insurance company to make sure your chosen plastic surgeon is an in-network provider. Here at, Aesthetic Surgery Associates, Dr. Charles R. Day is an in-network plastic surgeon with most major insurance carriers